This invention relates generally to a surgical-medical dressing designed to conform and adhere to areas of tissue either completely or partially denuded skin, and acts as a temporary synthetic skin. The wound is protected from exterior microbial attack and allows cellular elements of the tissue to become embedded with the dressing.
This synthetic skin is used primarily to cover tissue denuded of skin. The term "tissue denuded of skin" refers to any tissue which partially or completely has lost its skin coverage. Such tissue can represent fat, muscle, fascia, bone, tendon, cartilage, blood vessel, nerve or granulation tissue.
Such tissue denuded of skin can be clean, wherein no debris covers the exposed tissue. It can also be incompletely clean, wherein particles of debris (non-viable tissue, wound exudate, dried blood, etc.) are scattered throughout the wound. Tissue denuded of skin is found in a variety of illnesses, including skin abrasions, surgical wounds and amputations wherein the skin is not closed, decubitus ulcers, and burns, after the thermally injured skin has partially or completely separated from the underlying tissue. In certain deep burns, the skin has completely been destroyed and the physician may choose to treat the burn by removing all of the destroyed skin, leaving an exposed area of tissue denuded of skin.
Tissue denuded of skin presents several problems because of the loss of skin, among them: a barrier against external infection is lost, vital body fluids (water, electrolytes and protein) are lost through the open surface, and infection occurs in tissue denuded of skin because of proliferation of micro-organisms in the wound debris. In burns, microbial proliferation occurs in the thermally injured tissue, and in other wounds microbial proliferation occurs in the coagulum of blood and tissue fluids which accumulate in the wound surface.
Basic principles of therapy require that wound debris be removed from the wound surface. This includes necrotic tissue, wound exudate, foreign particles, dried blood, etc. A barrier against infection from the environment external to the wound must be provided. The infection already present in the wound must be controlled and the loss of vital body fluids from the wound must be reduced. Finally, the restoration of skin function is provided for by surgical replacement of the patient's own skin.
If the tissue is completely clean, it may be covered with the patient's own skin by means of a full-thickness or a partial-thickness skin graft or by means of a skin flap. Several situations arise in which the use of the patient's own skin is inadvisable. First, the denuded surface may be incompletely clean, in which case a skin graft may not be successful. Second, on an area of clean tissue partially denuded of skin, it would be desirable to apply a skin-like dressing; however, because such an area will heal without grafting, in time, it is not justifiable to use the patient's own skin as a temporary cover. Third, the patient may be too sick to tolerate an anesthetic and surgical procedure required to harvest skin grafts from him. Fourth, as in the case of massive third-degree burns, there may be insufficient amounts of the patient's own skin to cover the larger area denuded. In such cases, substitutes for the patient's own skin have been used advantageously.